NPIMap

Organization Active NPI

Third Coast Counseling Center

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1841387099
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801035829 Issued in MI
Legal business name
THIRD COAST COUNSELING CENTER
Practice address
1514 Wealthy St SE
Ste 260
Grand Rapids, MI 49506-2755
Phone
(616) 451-3008
Fax
(616) 451-3070
NPI assigned
Oct 9, 2006
Last updated
Jul 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. James C Mitchell, M.A., LMSW
Title
Therapist
Phone
(616) 451-3008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801035829 MI Primary

Addresses

Primary practice location

1514 Wealthy St SE
Ste 260
Grand Rapids, MI 49506-2755

Mailing address

1514 Wealthy St SE
Ste 260
Grand Rapids, MI 49506-2755
Phone (616) 451-3008

National Provider Directory

National Provider Directory

Locations

1514 Wealthy St SE
Ste 260
Grand Rapids, MI 49506
Phone (616) 451-3008

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1841387099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 WEALTHY ST SE",
            "address_2": "STE 260",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062755",
            "telephone_number": "616-451-3008",
            "fax_number": "616-451-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 WEALTHY ST SE",
            "address_2": "STE 260",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062755",
            "telephone_number": "616-451-3008",
            "fax_number": "616-451-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD COAST COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "616-451-3008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A., LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801035829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.